Supreme Court decision leaves Healthcare Reform Law intact

Supreme Court decision leaves Healthcare Reform Law intact

As reported here, and widely elsewhere last week, the 6-3 Supreme Court ruling in King v. Burwell on The Affordable Care Act (ACA), allowing federal subsidies for healthcare insurance in all states, means that nothing will change in the way the law is implemented. Maryland and DC have state/jurisdictional health care exchanges, and their insurance was not in question. But a decision the other way would have had a big impact in Virginia, and 34 other states that used federal exchanges in lieu of establishing state constructed and operated healthcare exchanges, www.healthcare.gov.

The requirement that all companies with 50 or more employees must offer affordable health insurance, as defined by the law, remains the same.

A few days before the ruling, the Congressional Budget Office estimated that rolling back the Affordable Care Act by ending insurance subsidies would increase the budget deficit by as much as $353 billion.

The Supreme Court decision dashes hope of opponents of the Affordable Care Act that it will be dealt a body blow harsh enough to kill it. Business groups will likely now urge Congress to make other changes to the health care law, such as changing the definition of –employee” from an individual working 30 hours a week to 40; ending the –Cadillac” tax on high-premium health care plans; repealing taxes on medical devices and insurance companies, and eliminating the employee mandate.

Republicans in Congress have said they plan to kill the ACA by defunding it through budget reconciliation in the fall. Such a measure would certainly be vetoed by the president. The Republicans are also working to push through some of the measures mentioned above. A bill to repeal the medical device tax passed the House the week before the Supreme Court ruling, by a margin just one vote shy of a veto-proof majority. President Obama has said he would veto it.

The House bill would cost less than previous versions because repeal would not be retroactive and so would not require tax refunds. But it would still add more than $24 billion to the deficit in the next 10 years, reports the Indianapolis Star.

In the Senate, Senate Finance Committee Chairman Orrin Hatch (R-Utah) has introduced a similar bill, but with so many other issues in the Senate, this one hasnêt even come up for debate. Some Senate Democrats have said they support repeal of the tax, but only if the cost is offset elsewhere which Sen. Hatchês bill does not do.

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